Claim total
$3,935.75
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2018-10-13
- Stop
- 2018-10-13
The parties
- Patient
- patient Rickey Arlen Murazik
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Aetna
Record id
1ba953e8-854b-0afe-0ce1-46dab5f80f84